A BSTRACT Complete heart block is seldom seen in pregnant women and poses a challenge for further management. The available literature on this is scarce, and the management usually varies as per the discretion of the obstetrician and severity of the presenting symptoms. Here, we report a case of a G2P0 primi with a high-degree AV block that was managed with a temporary cardiac pacemaker, which resulted in the successful delivery of twins. Clinically, we suspected a mitochondrial genetic defect to be the underlying cause of the conduction defect. Through this case, we would like to emphasize on the involvement of a multidisciplinary approach for the management of every pregnancy complicated by a medical disorder and the provision of timely interventions to reduce maternal and perinatal mortality.